Active NPI
Tamela Evans, NCC, LPC, ED.D.
- Professional Counselor
- Martinez, GA
National Provider Identifier
1295350080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-008818
- Practice address
- 4210 Columbia Rd Ste 11B
Martinez, GA 30907-0443 - Phone
- (757) 470-4348
- NPI assigned
- Jun 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-17952 | AZ | |
| Professional Counselor | 101YP2500X | LPC-008818 | GA | Primary |
Addresses
Primary practice location
4210 Columbia Rd Ste 11B
Martinez, GA 30907-0443
Mailing address
PO Box 2791
Show Low, AZ 85902-2791
Phone (757) 470-4348
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-17952 | AZ | MD | Professional Counselor |
| LPC-008818 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D. W. de Vose & Associates, LLC | Past | Accepting new patients | |
| Women'S Health Innovations of Arizona | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Martinez, GA
- NPI 1174139133
-
- Mental Health Counselor
- Gilbert, AZ
- NPI 1629560941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591574400000",
"number": "1295350080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2791",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859022791",
"telephone_number": "757-470-4348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 COLUMBIA RD STE 11B",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309070443",
"telephone_number": "757-470-4348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "TAMELA",
"name_prefix": "Dr.",
"credential": "NCC, LPC, ED.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-08",
"last_updated": "2020-06-08",
"certification_date": "2020-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-17952",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC-008818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.